inspiratory muscle training in cerebral palsy patients

Conditions: Respiratory Insufficiency

Summary: to evaluate the effectiveness of two protocols of inspiratory muscle training (imt) in cerebral palsy patients to improve respiratory strength and spirometric parameters. low-intensity vs high-intensity resistance training programs. evaluations: determination of the maximum inspiratory pressure (mip) and the maximum expiratory pressure (mep); spirometry - peak expiratory flow (pef), forced expiratory volume in first second (fev1) and clinical evaluations. the participants will be evaluated at the beginning and end of the intervention period. intervention: there are two groups of patients, one works with low loads (20% mip) and another with high loads (40% mip). they train 5 days/week 10 cycles lasting 1 minute. there is a rest of 1 minute between each cycle.

the study was a controlled, randomised, double-blind trial and with allocation concealment. the study protocol was approved by the bioethics committee of the university of salamanca (number of registry 678, 6th october 2021). participants: institutionalized people with cerebral palsy between 35 and 64 years were included, they were all members of aspace salamanca. all patients will be asked to carry out the 5-day weekly program, and a recording sheet will be provided to each participant so they will can record the time of each daily respiratory training session. all participants signed an informed consent form. the patients will be assigned to the two groups randomly. the main researcher doesn´t meet any of the participants until the initial assessment will be carried out. intervention: "high-intensity group". the device incorporates a unidirectional valve independent of flow to guarantee constant resistance and includes a specific pressure setting (in cm h2o). the intensity of the device will be 40% of mip. the protocol includes 10 cycles lasting 1 minute. the participants rest for 1 minute between each cycle. in total, the protocol includes 10 minutes of daily respiratory training. the patients will be instructed to inhale with enough force to reach the opening of the valve. "low-intensity group".the device incorporates a unidirectional valve independent of flow to guarantee constant resistance and includes a specific pressure setting (in cm h2o). the intensity of the device will be 20% of mip. the protocol includes 10 cycles lasting 1 minute. the participants rest for 1 minute between each cycle. in total, the protocol includes 10 minutes of daily respiratory training. the patients will be instructed to inhale with enough force to reach the opening of the valve.

Eligibility criteria:
inclusion criteria: * cerebral palsy patients * understand the objectives and be able to complete questionaires exclusion criteria: the presence of a respiratory disease in the previous month, inability to understand assessment tests or intervention or hemodynamic alterations (heart rate \> 150 beats per minute (bpm), systolic blood pressure \> 140 millimeters mercury (mmhg) or diastolic blood pressure \> 90 mmhg).

Keywords: aging cerebral palsy manova muscle strength older adults physical activity respiratory exercises